Sword Swallowers Association International
Application for Membership

Please complete all applicable fields with as much information as possible.
(*Fields marked with a red asterisk are required.)

Member Information
*First Name: *Last Name:
*Stage Name:
Sex: Date of Birth:
*Street Address:
Street Address (line 2):
*City: *State:
Zip Code: *Country:
*Telephone: *Mobile cell:
*E-mail: Web Address:
As an SSAI member, you can get a swordswallow.org e-mail address that will be forwarded to the e-mail address of your choice.
Preferred e-mail address: @swordswallow.org
E-mail address to forward to:
T-Shirt Size:  
       

Performance History
How long have you been swallowing swords?
What year did you begin swallowing swords? At what age?
How did you learn sword swallowing?
(check all that apply)
Self Taught  
Book or Article
Another Sword Swallower
Other Resource




Maximum number of swords swallowed at one time:
Longest blade swallowed:
Favorite sword to swallow:
What other specialties do you perform? (check all that apply)
Swallow neon tube Eating Glass Hypnotism
Swallow curved sword Walking on Glass Comedy
Swallow Kriss blade Walking on Hot Coals Juggling
Swallow Scissors Bed of Nails Unicycle
Human Blockhead Electrocution Stilt walking
Fire-eating Body piercing with skewers Snake Charming
Fire-breathing Weight lifting with body piercings Belly Dancing
Eating insects Magic Heavily Tattooed
Other:
Are you currently performing sword swallowing regularly?
Where or with whom do you currently perform?  
Name:
URL:
Name:
URL:
Name:
URL:
Are you interested in potential bookings through SSAI?

Profile Permissions
As part of your membership to SSAI, you will be listed on the list of Living Sword Swallowers on www.swordswallow.com. Before including information about you on the list of Living Sword Swallowers, we would like to know which material you would like us to use, and which you would like to keep private. SSAI does not sell or otherwise distribute this information. This information is for our private records and for a link to your listing on the web. We will keep any information that you deem private fully confidential.

* SSAI may publish my...:

Picture Real Name Contact Address
Contact Phone Contact Fax  

SSAI reserves the right to publish your email address, website url, stage name, state/province/region and country on the member profile pages.

In addition, you may publish a small series of links to other websites that are related to you and your performing on your profile page. Many people choose to offer links to the troupes that they perform with. Please enter any links that you would like to include on your profile page below: Enter the website address in the URL field and what you want the link to read as in the link text field.

URL:
Link Text:
URL:
Link Text:
URL:
Link Text:
URL:
Link Text:


Your profile may contain a short description of you or your show.
Please enter your profile/bio information below:


Suggestions and Comments


Benefits from SSAI: (What would you like to get out of SSAI?)


Suggestions for SSAI: (What would you like to see SSAI do?)


Contributions to SSAI: (What can you do to help SSAI? Regional Advisor? Lecturer? Marketing?)


Please feel free to submit any additional comments.



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